← Search & browse all drugs
ALIMENTARY TRACT AND METABOLISM › BILE AND LIVER THERAPY › LIVER THERAPY, LIPOTROPICS › Liver therapy
silymarin
A05BA03
Forms & Strengths
- Capsules: 140 mg, 150 mg
- Tablets: 70 mg, 140 mg
- Oral Suspension: 35 mg/5 mL
Adult Dosing
- Liver disease (chronic hepatitis, cirrhosis): 140 mg orally 2 to 3 times daily
- Amanita phalloides poisoning: 20 to 50 mg/kg/day intravenously divided into 4 doses (if IV formulation available) or high-dose oral
Pediatric Dosing
- Safety and efficacy in pediatric patients not well established
- Amanita phalloides poisoning (off-label): 20 to 50 mg/kg/day orally divided into doses
Indications
- Adjunctive treatment in toxic liver damage (e.g., Amanita phalloides mushroom poisoning)
- Supportive treatment in chronic inflammatory liver diseases and hepatic cirrhosis
Mechanism of Action
- Acts as an antioxidant by scavenging free radicals and increasing intracellular glutathione levels
- Stabilizes hepatocyte membranes to prevent toxin penetration
- Stimulates ribosomal RNA polymerase, promoting hepatocyte regeneration
Contraindications
- Hypersensitivity to silymarin, Silybum marianum (milk thistle), or Asteraceae/Compositae family plants
- Acute liver poisoning of non-amanita origin without specific indication
Adverse Reactions
- Mild gastrointestinal disturbances (diarrhea, nausea, dyspepsia, bloating)
- Allergic skin reactions (pruritus, rash)
- Mild laxative effect at high doses
Drug Interactions
- May inhibit CYP3A4 and CYP2C9 enzymes weakly, potentially altering levels of substrates
- Theoretical interaction with P-glycoprotein substrates
- May reduce efficacy of certain antiretroviral drugs via CYP/P-gp modulation
Curated Content: Needs Vetting Before Put to Clinical Use